Jacobs J E, Birnbaum B A, Langlotz C P
Department of Radiology, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
Radiology. 1998 Nov;209(2):411-6. doi: 10.1148/radiology.209.2.9807567.
To evaluate the belief that the frequencies of contrast material extravasation and minor, nonidiosyncratic contrast material reactions correlate with intravenous injection rates.
Complications of 6,660 consecutive injections of contrast material for computed tomography were prospectively recorded. Ionic (n = 4,851) or nonionic (n = 1,809) contrast material was injected at 0.5-4.0 mL/sec. The injection rate was 1.9 mL/sec or less in group 1 (n = 2,899), 2.0-2.9 mL/sec in group 2 (n = 2,475), and 3.0-4.0 mL/sec in group 3 (n = 1,286).
The extravasation rate (0.6%) did not differ significantly between the groups. The reaction rate (8.4%) also did not differ significantly between the groups. The rate of minor reactions (8.0%) was higher with ionic (9.9%) than nonionic (2.9%) contrast material (relative risk = 3.4). The rate of major reactions (0.4%) did not vary significantly with type of contrast material. The rate of nausea or vomiting (3.8%) did not differ significantly between the groups but was higher with ionic (4.9%) than nonionic (1.1%) contrast material (relative risk = 4.5). The rate of severe warmth (2.1%) was significantly higher in group 3 (2.8%) than group 1 (2.0%) or 2 (1.8%).
No correlations exist between injection rate and extravasation rate or overall reaction rate.
评估关于对比剂外渗频率以及轻微、非特异性对比剂反应与静脉注射速率相关的观点。
前瞻性记录连续6660次计算机断层扫描对比剂注射的并发症。离子型对比剂（n = 4851）或非离子型对比剂（n = 1809）以0.5 - 4.0 mL/秒的速率注射。第1组（n = 2899）注射速率为1.9 mL/秒或更低，第2组（n = 2475）为2.0 - 2.9 mL/秒，第3组（n = 1286）为3.0 - 4.0 mL/秒。
各组间外渗率（0.6%）无显著差异。各组间反应率（8.4%）也无显著差异。离子型对比剂（9.9%）的轻微反应率（8.0%）高于非离子型对比剂（2.9%）（相对风险 = 3.4）。严重反应率（0.4%）随对比剂类型无显著变化。各组间恶心或呕吐率（3.8%）无显著差异，但离子型对比剂（4.9%）高于非离子型对比剂（1.1%）（相对风险 = 4.5）。第3组（2.8%）的严重温热感率（2.1%）显著高于第1组（2.0%）或第2组（1.8%）。
注射速率与外渗率或总体反应率之间不存在相关性。
